Jobs Application LAKESIDE METAL SPECIALTIES, INC. LAKESIDE CONSTRUCTION FASTENERS, INC. Employment Application Applicant InformationFirst Name*Last Name*Today's Date* Street AddressApartment # / SuiteCity*State*Zip*Phone*Email* Date Available* Desired Salary*Position Applied For*Are you a citizen of the United States?*YesNoIf not, are you authorized to work in the U.S.?YesNoHave you ever worked for this company?*YesNoIf so, when?Have you ever been convicted of a felony?*YesNoIf so, when?Within the last 5 years have you been convicted of or released from incarceration for a misdemeanor which was not a first offense for, drunkenness, simple assault, speeding, a minor traffic violation, or disturbing the peace?YesNoEducationHigh SchoolAddressDatesDid you graduate?YesNoDegreeCollegeAddressDatesDid you graduate?YesNoDegreeOtherAddressDatesDid you graduate?YesNoDegreeReferencesFull NameAddressCompanyPhoneRelationshipFull NameAddressCompanyPhoneRelationshipFull NameAddressCompanyPhoneRelationshipWork Experience (Beginning with the current or most recent)CompanyPhoneAddressSupervisorJob TitleStarting SalaryEnding SalaryResponsibilitiesDatesReason for leavingMay we contact your previous supervisor for a reference?YesNoCompanyPhoneAddressSupervisorJob TitleStarting SalaryEnding SalaryResponsibilitiesDatesReason for leavingMay we contact your previous supervisor for a reference?YesNoCompanyPhoneAddressSupervisorJob TitleStarting SalaryEnding SalaryResponsibilitiesDatesReason for leavingMay we contact your previous supervisor for a reference?YesNoMilitary ExperienceBranchDatesRank at DischargeType of DischargeIf other than honorable, explainEmergency ContactNameRelationshipTelephoneCell PhoneAdditional InformationDisclaimer and SignatureI certify that all answers and statements given by me are true and correct without reservations of any kind and that no attempt has been made by me to conceal pertinent information. I hereby consent to allow Lakeside Metal Specialties, Inc./Lakeside Construction Fasteners, Inc. to perform a background check. If employed, I will comply with all company regulations. I authorize my former employers, schools, and references to give any job-related information they may have regarding me. I hereby release them and their companies from all liability for issuing such information. If upon investigation anything on this application is found to be false, misleading, or detrimental to the company’s operations in any way, I understand that I will be subject to dismissal from employment at any time during my period of employment. Lakeside Metal Specialties, Inc./Lakeside Construction Fasteners, Inc. participates in E-Verify to make employment eligibility determinations in accordance with federal agencies. I fully understand that any offer of employment will be subject to the company’s regulations regarding physical examinations, security investigations, and any other qualifying tests required. If such an investigation and report is made, I understand that I have the right to make a request for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.SignatureDateDO NOT WRITE BELOW THIS LINEInterviewed byNeatnessAbilityHired ByStart DateSalaryPhoneThis field is for validation purposes and should be left unchanged.